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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � Permit Number: wRECEIVED MAR 16 2020 Building Permit Application - Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division / 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: �* PRC?PO- ED i'MRROVE ENT LOCATION. �`�► Address: 7�`Z.5 M -1 lb Property Tax ID#: ,3 1��C.,' (,Q �C.(J ' tJ�.S`1' ®cX/ "7 Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION ©F VtIORK: CONSTR'U KNOWN Additional work to be performed ;underthis permit—check all that apply: Mechanical _Gas-Tank- "' T Gas,Piping _Shutters, ~`-Windows/Doors ` _Electric _ . 'Plumiiing `, Sprinklers _Generator Roof- Pitch Total Sq. Ft of Constructions Sq. Ft. of First Floor: Cost of Construction:$ V ig-d . Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: n NamJ e w ,I✓tom k--' " 'Name: Address: /n be_,_- La = Company: :: . City: I'n orrt $a,4� Lac cam ' State:. Address: 643. Zip Code: �L'1 Gl 4•;, Fax City: .lam s r� /,lti State:'G< Phone No. Zip Code: 3`-{lf 67 , Fax:- E-Mail: Phone No -`l� .. ._ -_ Fill in fee simple Title Holder on next page(if different E-Mail -t-Ct.vcan�c nL� from the Owner listed above) State or County License Cie OSS 7 U If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTA CONSTR CTIO IEN LA I �+RM TION: DESIGNER/ENGINEER: ' Not Applicable MORTGAGE COMPANY: =Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do_ the•work and:in'tallation as indicated. I certify that no work or installation has commenced prior to the issuance,of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested per'mif, I do,hereby agpgj�that I will,in:all respects,perform'the work in accordance with the approved plans,the Florida Building Codes and'St.Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA t STATE OF FLORIDA _ COUNTY OF �� L.,IIC COUNTY OF The forgoing instrument was lacknowledged before me The forgoing instr ent w acknowledged before me this�day of�� J 20Z0by this day of 20J by ��e; el lZ 66 INS F.zyi & d 'w; Name of person making statement. Name of person making statement. / Personally Known OR Produced Identification Personally Known OR Produced Identification r Type of Identification Type of Identifica i L D� Produced Produced (Signature .f Notary Public-State of Florida) (Si - Ile KAREN S. NIELSEN Commissi [o1YPJ% KAREN S. NIE IN Cotate of Florida-Notary Publial) da NotaYy �blic .- 207484 •_ Commission #GG 207484 ;,� fQ My Commission Expires N A.,f'ei;cpriissien Expires /, OF f��\ Jude 12, 2022 REVIE ERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19